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"The test will be a simple one: Are you sufficiently loyal to the president? If the answer is no, it will result in the denial of lifesaving disaster relief, funding for research into cures, the closure of Head Start offices, and more."
A Trump White House plan to give political appointees more power over federal grant money has sparked alarm among scientists, public health organizations, environmental groups, and others who fear that the proposal amounts to an attempt to subordinate critical funds to the whims of the president and his far-right allies.
More than 300 organizations signed a joint letter on Friday calling on White House budget director Russell Vought, the proposed rule's architect, to extend the public comment period that's set to end on July 13, warning that the "scope and impact of [the Office of Management and Budget's] rule is vast."
"The rule will impact the entirety of government grant-making across the United States," the groups warned. "OMB itself says the revisions suggested would relate to over $179 billion of funds to small entities."
Politico, which exclusively obtained the letter, noted that the "proposed rule has already garnered over 15,000 public comments, with many expressing alarm that the changes could undermine research across fields."
Under Vought's rule, federal agencies would be required to perform "pre-issuance reviews" of federal grants—funds appropriated by Congress—to ensure their distribution is consistent with "applicable law, federal agency priorities, and the national interest."
The rule lays out a number of standards that political appointees at federal agencies must screen for when deciding whether an organization can receive federal grant dollars. For instance, the rule would prohibit the distribution of federal grants to organizations that "promote anti-American values" or support "ideologies that deny the biological reality of sex or the sex binary in humans."
The New York Times reported that the consequences of Vought's rule "could fall hardest on health and science, a field in which [President Donald Trump] has pursued some of the steepest cuts in his second term."
"In exchange for federal assistance, researchers would face limits on the subjects that they can explore, the foreign labs with which they may collaborate and even the conferences at which they can appear," the Times noted. "Dr. Georges C. Benjamin, the chief executive of the American Public Health Association, a professional organization and advocacy group, said the policy could 'devastate innovation, science, and research' in the United States."
"This is an executive power grab that would hand presidential political appointees unchecked control over more than a trillion dollars that Congress appropriated in the interests of all Americans."
Earlier this month, Lawyers for Good Government and the Environmental Protection Network said that "if finalized, the rule would put senior political appointees in charge of approving and canceling individual grants, while stripping recipients of due process rights" while attaching "ideological conditions to nearly every federal dollar, raising First Amendment and equal-protection concerns."
The two organizations published a fact sheet warning that the proposed rule has the potential to halt billions of dollars in funding that communities across the US depend on for "health, public education, scientific research, public safety, and economic development projects."
“This is an executive power grab that would hand presidential political appointees unchecked control over more than a trillion dollars that Congress appropriated in the interests of all Americans,” said Jillian Blanchard, senior vice president for climate change and environmental justice at Lawyers for Good Government. “Conditioning funding for critical programs on ideology and viewpoint discrimination, while erasing basic due-process protections, violates freedoms of speech, equal protection, and eviscerates Congress’ power of the purse.”
Democratic lawmakers have also sounded the alarm about Vought's proposal. Rep. Rosa DeLauro (D-Conn.), the top Democrat on the House Appropriations Committee, said Thursday that she has given her Republican colleagues two opportunities to denounce Vought's rule—and they declined both times.
"Vought continues to attempt to steal from communities across the country. Now, he is trying to set a new political test on grants for a wide swath of the federal government," said DeLauro. "The test will be a simple one: Are you sufficiently loyal to the president? If the answer is no, it will result in the denial of lifesaving disaster relief, funding for research into cures, the closure of Head Start offices, and more. If you are not loyal enough, if you speak out against this administration, the president and his cronies will take away resources Congress provided."
"Italy is indebted to Cuba," the letter states. "Every day of silence has a cost in human lives."
As of Wednesday, more than 8,000 Italian medical and scientific professionals have signed an open letter acknowledging their indebtedness to Cuban doctors and condemning the tightening of the 65-year US embargo on Cuba by President Donald Trump as he threatens "take" the island.
"Over the decades, Cuba has built a health system that was considered an international model, capable of guaranteeing universal access to care even in limited resource conditions. Since 1963, more than 600,000 Cuban health workers have served in more than 160 countries, including Italy," states the letter addressed to Italian Prime Minister Giorgia Meloni and Health Minister Orazio Schillaci.
"That system is currently in a state of collapse," the letter continues. "Survival in childhood cancers has fallen from 80% to 65% due to the lack of first-line drugs."
The publication notes that "96,000 people—almost 1% of the population—including 11,000 children are on the waiting list for surgery. If the situation does not change, the list could affect 160,000 patients by the end of 2026. Over 300 pediatric surgeries per week are compromised by shortages of drugs, oxygen, anesthetics, and consumables."
"The crisis has its roots in a combination of factors that have progressively worsened," the letter continues. "The tightening of the economic embargo during the first Trump administration, Covid-19, and, since January 2026, the near-total blockade of energy supplies following the Venezuelan crisis have deprived the island of fuel, electricity, and access to international drug and medical device markets."
A report published in April by researchers at the Center for Economic Policy and Research confirmed an “unprecedented increase” in Cuba’s infant mortality rate, which soared 148% between 2018 and 2025.
Report co-author Joe Sammut said that “the blockade has had a particularly dire effect on Cuba’s healthcare infrastructure, with frequent power outages" exacerbated by the US oil blockade "interrupting the use of critical equipment for the treatment of patients, including incubators for premature babies, and ventilators to help sick newborns breathe."
The United Nations General Assembly has overwhelmingly condemned the broader US embargo—which Cuba’s government says has cost the island's economy more than $1 trillion over seven decades—33 times.
"The collapse of a health system is not just a local tragedy: It is a violation of fundamental human rights that requires a response from the global community, beyond any political assessment of the Cuban regime," the Italian letter argues.
"Italy cannot remain indifferent or silent, also because it is indebted to Cuba for the help received during the Covid-19 pandemic and for the current work of Cuban doctors in the Calabria Region to guarantee the functioning of the local health service," the publication adds.
The Trump administration has been pressuring Italy to curb its use of Cuban doctors, who are essential to Calabria's healthcare system.
"It is the duty of the global health community—doctors, researchers, institutions, scientific journals—but also of the civil community to act without ambiguity, in compliance with the fundamental principles of humanitarian law," the letter concludes. "Every day of silence has a cost in human lives."
“After the sudden and devastating pullback from US assistance in 2025, governments are now being pressured to accept agreements with contingencies that jeopardize human rights."
The Trump administration is requiring African nations to agree to a series of "troubling conditions" to restore lifesaving health aid, according to a Human Rights Watch report on Monday.
The administration's abrupt shuttering of the US Agency for International Development (USAID) last year shut off billions of dollars and caused havoc across Africa's healthcare system, resulting in what public health models project could be hundreds of thousands of preventable deaths.
But under what has been dubbed the “America First” Global Health Strategy, the administration has negotiated secretive agreements with dozens of these countries to restore some of the funding. Most of them have been kept under lock and key by the US.
Those that have been made public have come with terms that Human Rights Watch said "raise concerns that health aid is being inappropriately leveraged to extract terms beneficial to the US in negotiations around natural resources and access to sensitive health data from recipient countries."
In March, a draft memorandum of understanding with the government of Zambia was revealed to have conditioned $1 billion for HIV, tuberculosis, malaria, and other disease prevention for millions of people, on the country's acceptance of a separate bilateral treaty that would have given US companies greater access to the country's minerals.
A leaked State Department memo, prepared for Secretary Marco Rubio, put the exploitative terms plainly: “We will only secure our priorities by demonstrating willingness to publicly take support away from Zambia on a massive scale.”
After the details of that agreement were met with backlash, the text of agreements with several other countries—Ethiopia, Kenya, Mozambique, Nigeria, and Uganda—were suddenly removed from the State Department’s Freedom of Information Act Library.
A Human Rights Watch assessment of the agreements with those five countries—as well as agreements with Rwanda and Liberia that were leaked—revealed that in order to restore a portion of the more than $800 million collectively stripped from them by the US, they'd have to agree to several coercive measures that jeopardize the reproductive and privacy rights of their citizens.
“The agreements show the US intends to condition vital health assistance for millions of people on acquiescence to troubling conditions,” said Julia Bleckner, senior health researcher at Human Rights Watch. “After the sudden and devastating pullback from US assistance in 2025, governments are now being pressured to accept agreements with contingencies that jeopardize human rights.”
All seven of the agreements require the governments to provide the US with "broad access to data and information" to monitor compliance with the Helms Amendment, which forbids the use of US foreign assistance to pay for abortion care.
The agreements with Mozambique, Rwanda, and Liberia require them to provide “any data” requested by the US to ensure compliance with the amendment, while Uganda's permits the US to conduct unannounced spot checks of health facilities and clinics.
"By making a broad package of health aid contingent on broad and potentially invasive surveillance of Helms compliance, the agreement could encourage a more restrictive regulation of abortion than national law mandates and give rise to further violations of the right to healthcare,” says the report.
The agreements also give the US permission to directly audit clinics, laboratories, and health programs to ensure compliance with the conditions. Six of them require clinics to provide access to "any data" requested by the US at a sample of facilities it chooses.
Agreements with five countries also mandate that they share biological specimens taken from patients and associated information related to novel infectious diseases, which HRW described as part of an effort to undermine a global pathogen access and sharing system being created by the World Health Organization, from which Trump has removed the US.
HRW said in a news release:
The agreements raise serious concerns about use of people’s private health data, without clear limits, uniform safeguards, or meaningful protections for patient confidentiality, including in several countries with weak or absent domestic data protection laws. The agreements contain no prohibition on this data being shared with US pharmaceutical companies without patient consent.
“Governments negotiating health assistance agreements with the United States face difficult choices,” Bleckner said. “They should be wary of terms asking them to sign away their populations’ rights and push for the inclusion of civil society representatives and multilateral global health organizations like the Global Fund in deliberations.”